Ch 29

Question 1

Technique for mechanically circulating and oxygenating blood outside the body

Answer 1

Extracorporeal circulation or cardiopulmonary bypass

Question 2

Surgical techniques that improved the delivery of oxygenated blood to the myocardium for clients who have coronary artery disease (CAD)

Answer 2

Myocardial revascularization

Question 3

Surgery improves myocardial oxygenation by bypassing or detouring around the occluded portion of one or more coronary arteries with a relocated blood vessel

Answer 3

Coronary artery bypass

Question 4

A coronary artery bypass is performed when
SATA (3)

Answer 4

-The client has multiple coronary artery occlusions
-The anatomic location of the occlusion interferes with the safe insertion of a coronary artery catheter
-The heart cannot be repaired

Question 5

Disadvantages of cardiopulmonary bypass

Answer 5

Necessity for anticoagulation
Risk for stroke, arrhythmias, and renal failure

Question 6

Alternative harvesting vessels for grafting include the following SATA (4)

Answer 6

-the internal mammary and internal thoracic arteries in the chest
-the basilic and cephalic veins in the arm
-the radial artery in the arm
-the gastroepiploic artery from the stomach

Question 7

Does not involve the use of a cardiopulmonary bypass machine. Surgeon keeps heart beating at slow rated (40) with drugs

Answer 7

Off pump coronary artery bypass (OPCAB)

Question 8

Drugs used during OPCAB

Answer 8

Adenosine (Adenocard)
Esmolol (Brevibloc)

Question 9

Opening adhesions in the valve cusps, which is done without direct visualization of the valve

Answer 9

Commissurotomy

Question 10

Valve repair

Answer 10

Valvuloplasty

Question 11

Repair of the fibrous ring that encircles the valve

Answer 11

Annuloplasty

Question 12

Procedures that surgically tighten an incompetent valve

Answer 12

Valvuloplasty
Annuloplasty

Question 13

Disadvantages of mechanic heart valves

Answer 13

Risk for thrombi and emboli
Anticoagulation necessary
Risk for bleeding

Question 14

Types of heart valves

Answer 14

Mechanical
Allograft(homograft)

Question 15

Compression of the heart with accumulating blood

Answer 15

Cardiac tamponade

Question 16

Adults, heart transplantation is indicated for

Answer 16

Cardiomyopathy
End stage CAD
End stage HF

Question 17

Newborns & infants, heart transplantation is indicated for

Answer 17

Several congenital cardiac defect
Performed only when other treatment modalities fail or are unavailable

Question 18

Central venous pressure

Answer 18

Right atrial pressure
The pressure produced by venous blood in the right atrium

Question 19

Most common artery used in placement of direct BP monitoring

Answer 19

Radial artery

Question 20

Occurs within a few minutes of the transplant when the donor organ and recipient are extremely mismatched

Answer 20

Hyperacute rejection

Question 21

Occurs from 1 week to 3 months after the transplant; almost all transplant recipients experience to some degree

Answer 21

Acute rejection

Question 22

May occur anytime over the remaining lifetime of a recipient, causing varying degrees of damage to the donor heart

Answer 22

Chronic rejection

Question 23

The transplanted heart beats faster than the clients natural heart (100-110) because the nerves that affect the HR have been severed

Answer 23

Cardiovascular disease

Question 24

Resection and removal of the lining of an artery

Answer 24

Endarterectomy

Question 25

Endarterectomy performed to remove obstructive atherosclerotic plaques from

Answer 25

Aorta
Carotid
Femoral
Popliteal arteries

Question 26

When thrombi or emboli occlude a major vessel a __ is performed

Answer 26

Thromboectomy or embolectomy

Question 27

Direct BP monitoring may be used in clients with

Answer 27

Severe and sustained hypertension or hypotension and during and after cardiac surgery

Question 28

Retrograde pressure from the fluid on the left side of the heart at the end of left ventricular diastole

Answer 28

Pulmonary capillary wedge pressure